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General NPI Number Information
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NPI Number | 1245319235
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Entity Type | Organization
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Legal Business Name | ABDAS ARTIFICIAL EYE AND FACIAL CENTER INC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 3715 WILLIAMS BLVD STE 207
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City | KENNER
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State | LA
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Zip | 70065-3075
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Country | US
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Telephone | 504-469-3937
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Fax | 504-469-3377
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Provider Business Mailing Address
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Address Line | PO BOX 415
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City | KENNER
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State | LA
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Zip | 70063-0415
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Country | US
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Telephone | 504-469-3937
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Fax | 504-469-3377
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD CHARLES ABDA
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Credential | OCULARIST
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Telephone | 504-469-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 1508
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License Number State | LA
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